THE MILTON KEYNES HOSPITAL ART COLLECTION Evaluation Report
Dr. Laura McGrath and Dr. Nicola Magnusson
EXECUTIVE SUMMARY
Background and purpose
The art collection owned by Milton Keynes University Hospital (MKUH) has been a feature of the hospital since it was built in 1984. Since 2004, Arts for Health Milton Keynes (AfHMK) have been employed by MKUH to manage the collection of around 450 works. This evaluation aimed to answer three main questions:
• How do users of the hospital perceive and experience the art collection?
• What is the Theory of Change for the art collection?
• What barriers and challenges are there in managing the art collection?
In answering these questions, this evaluation aimed to provide a basis for a shared understanding of the purpose of the art collection and a clarification of the mechanisms through which it may impact users of the hospital.
Methods
A mixed methods process evaluation was conducted. Eight key informant interviews were carried out with respondents who work with the art collection. These included staff, volunteers and artists from AfHMK, and hospital staff including from the hospital charity, patient experience, wellbeing and estates.
A survey was also conducted with users of the hospital (staff, patients, visitors, carers and others). Of 87 responses, 21 were gathered online and 66 on site in MKUH. The survey was designed to gain insight into the emotional impact of the art, as well as how art impacted perceptions of the hospital environment.
Key findings
There was clear agreement across the interviews and the survey responses in identifying the ways in which the artwork could impact wellbeing of users of the hospital. Key mechanisms identified were that the art could afford experiences of calm, uplifted mood and contemplation, providing a positive distraction from difficult experiences. Responses also indicated that the collection helped to make the hospital seem like a place which was caring, well-resourced and welcoming. Finally, the presence of art within the space of the hospital was described as contributing to people feeling valued and enriching the community life of Milton Keynes.
Recommendations
The collection is currently well perceived and there is evidence of positive impact on wellbeing. To maximise the impact of the collection for users of the hospital, we would recommend prioritising uses of the collection which afford the experiences and perceptions identified. These are for individuals: distraction, calm, uplift and contemplation; for the environment: care, abundance, and warmth; and at the place level: inclusion, value and cultural enrichment.
1. Placement
We recommend prioritising ‘dwelling places’ – places where patients, staff and visitors are still - for new art placement This is with an aim to maximise experiences of distraction, calm, contemplation, and uplift The current placement of art in corridors has a valuable role to play in improving the perception of the hospital environment and contributing to community wellbeing.
2. Selection
A significant barrier to expanding the placement of art in the hospital are the material qualities of the works in the collection. Works on wards need to be clinically safe, and these are spaces where it is harder to maintain works effectively. We recommend that the clinical safety of new works takes a higher priority in future selection.
3. Interactivity and visibility
Another route to engaging patients more with the art is to work more interactively with the collection and make it more visible through direct engagement. Any additional interactive project, however, would need to build on not detract from the core work of maintaining the collection.
4. Integrated working
Crucial to the success of these recommendations is strong collaborative working culture between AfHMK and relevant hospital teams. The project spans the worlds of arts and health. To aid collaboration and mutual learning we would recommend instituting a more formal joint working approach. An ‘arts programme group’ or similar who meet regularly to oversee the uses of the collection in the hospital could help to facilitate a more sustained approach.
BACKGROUND
Milton Keynes University Hospital (MKUH) is in the unusual position of being a hospital that has always had an art collection. Artists who were involved in the campaign to build the hospital in 1984 set up the collection, initially run through the Voluntary Hospital Arts Committee Since 2004, MKUH has employed Arts for Health Milton Keynes (AfHMK) to run and manage the art collectioni .
Today, the art collection consists of over 450 works and is the largest private art collection in Milton Keynes. Works include paintings, sculpture, textiles, photography, glass work, mural wraps, and mixed media. Sculptures are mainly displayed in the outside spaces –through the walkways and courtyards around the hospital site. The majority of artwork inside the hospital is hung in the corridors and main reception, with a smaller amount on display in wards and waiting areas. Some works are owned by MKUH, most via donations, while others are on loan – either from the artist themselves or via external schemes such as ‘Paintings in Hospitals’ii Other new works are brought in for temporary exhibitions, where an artists’ work is displayed for a set period in a part of the hospital.
The establishment of the collection should be seen in the context of the time, and the unique history of Milton Keynes. Part of the ethos of the ‘New Towns’, of which Milton Keynes was the largest and last, was a commitment to public and socially engaged art. ‘Town Artists’iii worked with development corporations, integrating art into the spaces of the New Townsiv . Underpinning this commitment was an idea that beautiful and interesting places, filled with art, promote community and individual health and wellbeing.
At the time the collection was established in MKUH, it was unusual to have much art in hospitals in the UK. In more recent years, however, there has been a significant interest in the role of art in improving healthv , and greater use of art in hospitals.vi This evaluation offers an opportunity to rethink the purpose and function of the collection within the contemporary context of the NHS.
This more recent body of work has tended to focus on individual level benefits from the presence of, or engagement with, art. The quality of this literature is variable, but studies have found improvements in moodvii and painviii as well as reductions in anxietyix Improved experiences of waiting have also been noted, seen in reduced restlessness, fewer queries at reception and increased social interaction in waiting areas where art was introducedx
Perceptions of the hospital environmentxi have also been found to be enhanced. There is debate between researchers over the type of art that should be displayed. Some researchers have argued strongly to prioritise natural scenesxii . Research comparing abstract and figurative art, however, did not find a strong preference amongst patientsxiii
One mechanism proposed for these relationships is positive distractionxiv. Having something to look at which provides interest beyond the immediate experience of the hospital has been argued to help in both boosting mood and changing the viewer’s experience of time. Another idea is that art helps to 'humanise' xv the hospital, playing a role in "addressing [patients] socially, culturally and existentially as individual human beings"xvi A final proposed mechanism is that having art on display can make the hospital seem well resourced and functional, increasing feelings of safety and securityxvii .
The MKUH art collection pre-dates this body of empirical evidence and its emerging understanding of potential relationships between art and wellbeing in hospital spaces There has not been an evaluation of the collection before; when it was set up there was no culture of evidencing impact in the way expected in contemporary health services. We therefore view this evaluation as the first stage in a longer process for MKUH and AfHMK to take forward. To aid in this process, this report will answer three main questions:
• How do users of the hospital perceive and experience the art collection?
• What is the Theory of Change for the art collection?
• What barriers and challenges are there in managing the art collection?
The primary aim of this evaluation is to provide a basis for a shared understanding of the purpose of the art collection and a clarification of the mechanisms through which it may impact users of the hospital. This includes evidence detailing how the art collection is perceived by those using the hospital
METHODS
A mixed methods process evaluation was conducted. This kind of evaluation aims to identify and understand the processes involved in a project or intervention, including its institutional context xviii
The evaluation was ethically approved by the Open University Ethics Committee. The Open Psychology Research Centre also provided funding to support the data collection. There were two prongs to the data collection
Key Informant Interviews
Short interviews were conducted with key members of staff in MKUH and AfHMK. The purpose of these interviews was to understand and identify the ways in which the collection was understood and viewed by those who work closely with it, as well the institutional context. Interviews were conducted with staff, volunteers and artists involved in AfHMK. Hospital staff interviewed included those in the wellbeing, patient experience, and estates teams, as well as the hospital charity.
Survey
A survey was created to gather information on how the collection was perceived and experienced by users of the hospital – staff, patients, visitors, carers, and others. The survey asked respondents about their reasons for being in the hospital, their general perception of the hospital environment, and the impact of the art on their individual emotional states and perceptions of the hospital environment.
Perception of the hospital environment
To measure the general perception of the hospital environment we used a question from a US study xixwhich had also looked at the impact of art in a hospital environment. They asked participants if they had noticed the art, and to rate to what extent they thought the hospital environment was: ‘healing’, ‘inspiring’, ‘stark or bare’, ‘inviting or welcoming’, calming’. We included both these questions in the survey.
Emotional response
To measure the emotional impact of the art we used the ’circumplex’ model’ of emotionxx . This is a well-established model of emotional experiences which has been used in many
research studies, meaning the categories are well tested. It proposes that emotions vary on two dimensions: from pleasant to unpleasant, and from activated to deactivated. These combine to produce the full range of emotional experience. Someone feeling excited, for instance feels ‘activated’ in a ‘pleasant’ way. Feeling sad, on the other hand, involves feeling ‘deactivated’ in an ‘unpleasant’ sense; the ‘pleasant’ version of feeling ‘deactivated’ is tranquility. We used a version of this model with ten categories, and asked respondents to rate their response to the art on each. These were: ‘happy or satisfied’; ‘inspired or enthusiastic’ , ‘interested or alert’, ‘anxious or jittery’; ‘scared or fearful’; ‘guilty or ashamed’; ‘sad or gloomy’; ‘bored or dull’; calm or tranquil’.
Demographics
Standard demographics questions were adapted from the Arts Council ‘Illuminate’ audience survey. Questions were included on age, occupation, ethnicity, sex, gender identity, sexual orientation and neurodiversity. All questions had a ‘prefer not to say’ option.
KEY FINDINGS
The findings of the evaluation are organised into four sections, which answer these four questions:
1. What is the purpose of the collection?
Drawing on information from key informant interviews, informal conversations, and reviews of key documents
2. How do users of the hospital perceive and experience the art collection?
This question is answered using the survey responses. We report the results of the survey including qualitative and quantitative responses.
3. What is the ‘Theory of Change’ for the MKUH collection?
Drawing together evidence from the survey and interviews, we propose a Theory of Change for the art collection.
4. What barriers and challenges exist when managing the art collection?
Barriers and challenges have been identified through the key informant interviews and ongoing engagement with AfHMK and MKUH staff.
PURPOSE OF THE COLLECTION
The ‘Collection Development and Management Policy’ has a helpful summary of the perspective in AfHMK:
“The agreed purpose of The Collection is to enhance the environment of MKUH, to cheer, soothe and offer a pleasing distraction for patients, staff, and visitors; as well as to support general health and wellbeing through access to creativity. It is also acknowledged that The Collection is of value to the people of Milton Keynes and the surrounding areas, and the artistic community as a whole.”
This characterisation of the purpose of the collection was reflected across the key informant interviews from AfHMK related participants. We can draw out these main claims:
The collection enhances…
Wellbeing of hospital users
The hospital environment
Community wellbeing
Cultural life of Milton Keynes
Also important are ideas about the mechanisms involved in achieving these improvements, or how the collection is thought to work. These were the key ideas which we identified in the interviews with AfHMK participants and confirmed in later discussions
(i) Individual emotional benefits
Distraction Calm
“I think the art can distract. It can take their mind off the immediate and cause them to think about something […] it can give them a little break”
“It can transport you to another place”.
“I remember one of the visitors commenting positively on how calm that was”.
Joy and pleasure
“Sometimes it’s just pleasure, it’s colour as well”
Contemplation
“Sometimes it does give people space to meditate or contemplate”
Care
(ii) Environmental enhancement
“More care about the place”
Value
“[The art makes people feel that] we’re important enough to come in here and put that work on the wall […] someone has taken time and care to make the environment look nice”
Humanisation
“softens the environment”
(iii) Cultural enrichment
Meaning and connection
“Work people can resonate with”
“It’s good quality it makes people think and it’s engaging”
Inclusion
“It makes it more accessible than being in an art gallery […] I would never have thought that I could be in contact with art from those sorts of people”
“The artwork is there and it is on display and it’s for the people of Milton Keynes”
The collection is understood, therefore, as enhancing the wellbeing of hospital users, the environment of the hospital, and the community of Milton Keynes as a whole. Key mechanisms identified include promoting calm, improving mood, as well as providing a distraction and vehicle for contemplation. The collection is also thought to aid in a perception of the hospital as caring, welcoming, and inclusive.
The next section will present findings from the survey of hospital users, before considering how the experiences of users compare to the perspectives of those working with the collection.
HOSPITAL USERS: SURVEY RESULTS
There were 87 respondents to the survey. 66 completed the survey face-to-face and 21 online. Face to face responses were gathered in person in the hospital. The majority of participants were asked to take part in the public areas of the hospital, with the largest number being approached in the main reception area. Facilitated by the patient experience team, a smaller number of patients on wards were also surveyed.
Survey respondents
Responding to the survey were a relatively even mix of staff, patients, and other hospital users:
Of the staff respondents, 21 worked on-site and two in the community. There was a variety of staff roles represented, including medical, administrative, and domestic staff. There were more outpatients (21) than inpatients (9), due to access issues. ‘Other’ users included eight people visiting and 10 people accompanying patients. Six respondents did not give a reason for being at the hospital or a role.
76 respondents completed at least some of the demographic information. Respondents were asked to state their ethnicity, sex, gender identity, age, occupation, and whether they had a disability or neurodiversity. These are reported on the following page.
Age and occupation
The respondents had a spread of ages, skewed to an older age group as might be expected in a hospital. Similarly, the largest occupational group were retired people.
Sex and gender
More women than men responded to the survey (57% vs 43%). All participants had the same gender identity as their sex.
Ethnicity
Ethnicity
Other
Anglo/Fijian
African Ghana
Black/Black British
Asian/Asian British
White/White British
Our sample was 86% White British, which is higher than the Milton Keynes population of 72%xxi
Disability and neurodiversity
We had more disabled respondents (37%) than the population of Milton Keynes (17%)xxii . This again might be expected in a hospital sample. 14% of participants identified themselves as being neurodiverse
Overall, the demographic profile of the participants was a little older, more disabled, whiter and more female than the general population of Milton Keynes. It is worth bearing these skews in the data in mind when interpreting the results of the survey.
Frequency of visit
Respondents were asked how often they visited Milton Keynes University Hospital:
How often have you visited MKUH in the past six months?
Of those respondents who were at the hospital ‘most days’, the majority were staff. The ‘not at all’ response is from an online participant. Eight respondents did not answer this question.
Interest in art
Finally, we asked respondents how interested they were in art:
There was an even spread amongst those who responded to this question across interest levels in art. This indicates that the survey was successful in reaching people without an inherent interest in art.
Perceptions of the hospital environment
Before asking respondents about the art specifically, we asked about their general perception of the hospital environment:
The strongest response was to the word ‘inviting’, which had an average response of 3.6 out of 5. Calming and healing were also just in the positive category, with average responses of 3.1 and 3.0 out of 5. ‘Stark’ was negatively responded to overall. It is worth noting that these terms were drawn from a US study and ‘healing’ and ‘inspiring’ did not seem to resonate well with participants when completing the survey face to face. Nevertheless, overall, MKUH seems to be perceived as a place which is inviting, and not stark.
Influence of the art collection
The next question the survey tried to answer is whether the art affected people’s perceptions of the environment. Firstly, we asked people if they had noticed the art in the hospital
All those who said no were patients, and all but one were in the least frequent category for visits in the past six months
Respondents were also asked what difference they thought having art up made to the hospital environment overall:
Having art up in a hospital makes it seem like a place which is...
The two positive responses from this question were to ‘homely’ (3.1) and ‘caring’ (3.3). This is in line with the data from AfHMK interviewees, who also identified that the collection could make the hospital seem like a softer, kinder and more caring place. There was also a strongly negative response to ‘struggling’ (1.2). This is interesting in light of the research which proposed that art was seen as an ‘additional extra’ by patients, which in turn reassured them that the hospital had enough resources to provide good carexxiii. This may therefore indicate a route to patients feeling more secure and safer when using the hospital, although ‘safe’ did not get an explicitly positive response.
Qualitative responses
There was also an open question asking respondents to contribute anything the art made them think or feel. Some of these comments were related to the environment.
Welcoming
“I think the artwork makes the environment more welcoming than when I attend Northampton which has very little”
Care,
respect
“The art is original art and appreciated and high-quality pieces are exposed. Makes me fell calm and respected because I feel someone has cared”
Colour, joy, pleasure
“I’m not a super arty person but it’s better than not having any and it brings colour to a clinical environment.”
“It’s absolutely gorgeous”
“I think it’s the juxtaposition to the concrete building. It gives inner calm as opposed to it being stark and clinical. It’s familiar colours instead”
These qualitative responses reaffirm that art is seen to make a hospital more caring, as well as explicitly linking the presence of art to creating a more welcoming environment. This is interesting as respondents reported that they found the environment of MKUH to be ‘inviting’, indicating the art collection may play a role in this impression Calm is also mentioned again, here in the context of the art helping to create an environment which is less ‘stark’ or ‘clinical’.
Overall, the qualitative and quantitative data indicates that users of the hospital saw the art as helping to create an environment which was perceived as caring, welcoming and warm. There were also indications that having an art collection contributed to feelings of being respected and a perception that the hospital was ‘not struggling’ and so able to provide good quality care.
Emotional impacts
Respondents were also asked about their emotional responses to the art. This question could help in understanding the mechanisms through which the art collection could help to facilitate wellbeing for users of the hospital. As outlined in the method section, we asked participants to think about a time when they had noticed the art, and then rate what that art had made them feel.
The art has made me feel...
As can be seen in the graph, respondents identified that the art in the hospital had made them feel only positive emotions. The responses for all the ‘unpleasant’ feelings, using the circumplex modelxxiv were negligible. The responses for ‘pleasant’ feelings, ranging from ‘enthusiastic (‘pleasant-activated’) through ‘happy’ (pleasant-neutral) to ‘calm’ (‘pleasantdeactivated’) were all within a similar range. There were no very strong effects, although ‘happy or satisfied’ (3.2) had the highest average score.
Qualitative responses
The open-ended comments on the survey included quite a lot of information about individual emotional responses to the art. Calm
“Feel more calm, it helps conversations and that makes me feel more at ease”
“Calming down the main corridor”
“It made me feel more relaxed”
Distraction
“Gives people a good feel-good factor, good environment if it was plain walls, it would be boring”
“Lifts the mood. Hospitals are not joyful, and it helps. Especially as it’s nice pieces.”
“Sometimes it’s just pleasure”
Uplift and pleasure
I noticed it when it wasn’t there, when it was, I momentarily forget where I am”
“Took my mind momentarily off the reason I was there”.
“I think it gives your mind something else to think about and a distraction. It offers something to look at other than why you’re here”
“It is especially good for visitors it makes them happy, and it gives them something to distract their mindset.”
Meaning and community
“Photograph of people at a bus stop reminded me of my late sister”.
“The work in my room is really uplifting and also quite emotional as my husband died nine years ago and we had a canal boat together”.
The textile piece by ward one is so pretty, and it takes me back to school and being taught how to sew back home”.
“It feels like the artist and public get involved in each other’s lives and it’s a good opportunity for staff too. We have local photos of MK so it’s lovely to see improvements.”
These quotes indicate a synergy between the experiences and perceptions of the users of the hospital, and the understanding of the collection held by AfHMK. Similar themes emerge here of the collection affording experiences of calm, distraction, and uplifted mood. It is a positive sign that users of the hospital independently identified similar experiences as the AfHMK staff and volunteers.
Users of the hospital also identified times when they had connected personally with some of the art collection, and that this personal, meaningful resonance was important. It is worth noting that the personal connections users described with specific art works are not particularly predictable, as they depend on what is personally meaningful for each person This could support maintaining a range of subject matters and art forms in the collection
THEORY OF CHANGE
‘Theory of Change’ xxv is a term for the assumed model which underpins an intervention or project. Having an explicit theory of change for a project can help to shape future development and facilitate shared understanding amongst those working on the project
The theory of change below draws together evidence from key informant interviews and survey responses and has been developed in consultation with staff working with the collection. We propose a multi-level model through which the collection can be understood to influence health and wellbeing:
Person
Enhancing staff and patient wellbeing Via: distraction, calm, uplift, contemplation
Environment
Enhancing the hospital environment Via: projecting care; abundance; warmth
Place
Enhancing community wellbeing Via: cultural enrichment, value, and inclusion
At the individual level, we have identified some key mechanisms through which engagement with the art collection can help to enhance wellbeing. In line with much of the literaturexxvi , we can understand the art collection as providing a positive distraction for users of the hospital as they navigate often difficult experiences. Specifically, the collection appears to facilitate experiences of calm and uplifted mood, as well as opportunities for contemplation and reflection.
At the level of the hospital environment, there is evidence from the survey responses that the art collection contributes positively to the perception of the hospital Specifically, having art in the hospital can be seen to make the hospital appear like a caring, warm, and welcoming place. There is also some indication that the art collection helps to make the hospital seem like a place which is well-resourced. These observations match up with prior research, which also found that art in a hospital setting creates an impression of warmth and carexxvii
Finally, there are indications that the collection contributes to an enrichment of community wellbeing for Milton Keynes as a whole. This level of impact was not directly measured in the survey, as it was not addressed in the existing literature. It emerged as a strong theme in the key informant interviews and through informal comments and open-ended responses from survey participants The collection provides access to art for people who would not necessarily seek it out in a gallery. In turn, there are indications this has positive impacts of helping people feel valued and included, as well as contributing to the cultural enrichment of the city. In healthcare terms, this can be viewed as an ‘upstream’ intervention, aimed at promoting public mental health and community wellbeing
CHALLENGES
The MKUH art collection is a valued asset by users of the hospital and those who work closely with it. Overall, it is perceived positively and there is emerging evidence to support its role in enhancing wellbeing at the individual, environmental and community levels. Through the interviews conducted for this evaluation and subsequent less formal conversations, we have identified some key challenges in effectively managing the collection and maximising its potential.
Translation between arts and health
The collection sits between two worlds: arts and health. The collection is owned by the hospital and designed for this environment; it must have a clear health and wellbeing impact. At the same time, the maintenance, curation, and future survival of the collection requires a high level of art expertise and connection into the art world. This includes the ability to attract artists to contribute to the collection and maintain art works to a professional standard, as well as the expert knowledge needed to select art works appropriate for a hospital setting. Many art works are on loan and their presence in the hospital depends upon the goodwill of artists. To thrive, the collection needs to speak effectively to both worlds, and there needs to be an articulation of its purpose in the languages of both arts and health.
The theory of change presented in the previous section is itself an example of this issue. It is written mainly in the language of health and wellbeing, developed for use within a health setting. Yet the aims, purpose and impact of the collection also needs to be articulated in language which makes sense in the art world. Without this, it will be difficult to attract artists to contribute to the collection or attract future funding from the arts and heritage sector. This might include framing the collection as ‘socially engaged art’ or ‘art for social impact’ and focus on the inclusive impact of bringing art into community spaces.
It is therefore crucial that both ‘sides’ of the project – arts and health – understand and respect the framing needed for the two contexts the collection works within. Sometimes messaging about the collection may have to be in ‘health’ language and sometimes in ‘arts and culture’ language; these are not opposing agendas, but both needed for the collection to function well and maximise its potential
Art placement
At present, most of the art collection is placed in the ‘public’ areas of the hospital, mainly the corridors. As demonstrated in the survey responses, this has some desirable effects of making the hospital seem a caring, welcoming and warm place. It was also evident in the survey that staff tended to be more engaged with the collection than patients or visitors. This is perhaps unsurprising, as staff are in the hospital daily, and are not ill or in crisis.
Most of the art, in addition, is placed in places where patients are likely to be in transit. Some of the survey respondents commented spontaneously on this issue. One outpatient commented that the art is often “hard to notice” stating that the “purpose of a visit to a hospital is not the same as the purpose of a visit to an art gallery.” By this she did not mean that the art should not be in a hospital, but that it should be used and placed differently than would be expected as a part of an art exhibition. An inpatient commented that they had noticed the art more when they were mobile, but now they were confined to bed did not encounter it. There was art on their ward, but it was in the nurses’ station not visible from the beds.
Placement is a complex issue, and not easily resolved. To be placed on wards, artwork needs to be clinically safe, and this limits the materials it can be made from. An oil painting, for instance, cannot be placed on a ward. With the existing collection, there are therefore limited works which can be used in this way. Placement on wards also requires buy in and cooperation from ward management, as well as ongoing commitment to preserving the artworks.
Collaboration and ownership
The organisational structure of the collection reflects the way that the project sits between the ‘two worlds’ of arts and health; it is owned by the hospital and managed by AfHMK. To maximise the potential of the collection, joint working between these two partners in the project would be optimal. An example of good practice was the collaboration between the Curator and Patient Experience team on a new sensory garden. There were other indications, however, that the different perspectives on the purposes of the collection had impeded joint work.
Visibility
The long history of the art collection in MKUH was seen as having both positive and negative implications. On the one hand, the richness of this history and the unusual size and diversity of the collection were described as assets for both the hospital and the wider Milton Keynes community. A downside highlighted by interviewees was that the collection was sometimes seen as “part of the furniture”. One survey respondent did indeed comment that they “take [the artwork] for granted”. Another survey respondent commented that people might not always recognise specifically how the artwork had affected them, even as they felt better in a space with art. A study which varied the presence of art in a hospital day room did find evidence to support this idea. Patients were more sociable, felt calmer and more secure when the artwork was present, but did not explicitly attribute these changes to the appearance of art on the walls.xxviii
The ’background’ quality of the art collection therefore poses some challenges One risk is that the collection could come to be seen as something which just exists, rather than being the product of ongoing active maintenance. In a study of an art collection in an Australian children’s hospital, the authors discovered abandoned and damaged artworks all over the hospital as the collection had not been actively managed or curated since it had been donated in the 1970sxxix A continued commitment to the work and time involved in maintaining the collection is therefore crucial, as well as continued recognition of the importance of this work. There are also a number of initiatives described by interviewees to draw attention to the collection, such as the ‘Look Around You’ trail around the hospital. Initiatives such as this could help to maximise the impact of the existing art work for users of the hospital.
RECOMMENDATIONS
Drawing together the findings of the report we have some key recommendations for future work with the collection.
Maximising the wellbeing impact of the collection
The collection is currently well perceived and there is evidence of positive impact on wellbeing. To maximise the impact of the collection for users of the hospital, we would recommend prioritising uses of the collection which afford the experiences and perceptions identified in our theory of change. These are for individuals: distraction, calm, uplift and contemplation; for the environment: care, abundance, and warmth; and at the place level: inclusion, value and cultural enrichment.
1. Placement
One way to maximise experiences of distraction, calm, contemplation and uplift could be to prioritise placing new art in places where patients and other hospital users are stationary. The current placement of art in corridors has a valuable role to play in improving the perception of the hospital environment and contributing to community wellbeing. We recommend adding to this existing impact by prioritising dwelling spaces – such as wards or waiting areas - for new art placements.
2. Selection
A significant barrier to expanding the placement of art in the hospital are the material qualities of the works in the collection. Works on wards need to be clinically safe, and these are spaces where it is harder to maintain works effectively. We recommend that the clinical safety of new works takes a higher priority in future selection.
3. Interactivity and visibility
Another route to engaging patients more with the art is to work more interactively with the collection and make it more visible through direct engagement. There are some good examples of practice in this area such as the ‘look around you’ project. We would recommend investigating other interactive projects, such as the possibility of an ‘Art Cart’ where patients select a work to hang near their bed for the duration of their stayxxx Any additional interactive project, however, would need to build on not detract from the core work of maintaining the collection.
4. Integrated working
Crucial to the success of these recommendations is strong collaborative working culture between AfHMK and relevant hospital teams. There are good examples already of joint project work and the curator works collaboratively across the estate to maintain and manage the collection. To aid collaboration and mutual learning across the arts/health worlds we would recommend instituting a more formal joint working approach. An ‘arts programme group’ or similar who meet regularly to oversee the uses of the collection in the hospital could help to facilitate a more sustained approach.
REFERENCES
i https://artsforhealthmk.org.uk/The-Collection-Story
ii https://www.paintingsinhospitals.org.uk/our-mission
iii Petherbridge, D. (1979) ‘The Town Artist Experiment’, Architectural Review, 990, pp. 125-129.
iv Harding, D. (1995) Public Art in British New Towns, accessed from www.davidharding.net, 16th July 2024.
v All Party Parliamentary Group on Arts, Health and Wellbeing. Inquiry Report. (2017). Creative Health: The arts for health and wellbeing. Retrieved from www.arthealthandwellbeing.org.uk/appg/inqui
vi Lankston, L., Cusack, P., Fremantle, C., & Isles, C. (2010). Visual art in hospitals: case studies and review of the evidence. Journal of the Royal Society of Medicine, 103(12), 490-499.
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x Nanda, U., Chanaud, C., Nelson, M., Zhu, X., Bajema, R., & Jansen, B. H. (2011). Impact of visual art on waiting behavior in the emergency department. The Center for Health Design’s Research Coalition
xi George, D., de Boer, C., Hammer, J., Hopkins, M., King, R., & Green, M. The value of integrating visual arts (VIVA): Evaluating the benefits of hospital room artwork on inpatient wellbeing.
xii Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H. B., Choi, Y. S., ... & Joseph, A. (2008). A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 1(3), 61-125.
xiii Baceviciute, S., Bruni, L. E., Burelli, P., & Wulff-Jensen, A. (2016). Art in Hospitals Project: Psychophysiology experiment.
xiv Lankston, L., Cusack, P., Fremantle, C., & Isles, C. (2010). Visual art in hospitals: case studies and review of the evidence. Journal of the Royal Society of Medicine, 103(12), 490-499.
xv Bates, V. (2018). ‘Humanizing’ healthcare environments: architecture, art and design in modern hospitals. Design for Health, 2(1), 5-19.
xvi Nielsen, S. L., Fich, L. B., Roessler, K. K., & Mullins, M. F. (2017). How do patients actually experience and use art in hospitals? The significance of interaction: a user-oriented experimental case study. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267343.
xvii Ibid
xviii Linnan, L., & Steckler, A. (2002). Process evaluation for public health interventions and research. JosseyBass/Wiley.
xix Karnik, M., Printz, B., & Finkel, J. (2014). A hospital's contemporary art collection: effects on patient mood, stress, comfort, and expectations. HERD: Health Environments Research & Design Journal, 7(3), 60-77.
xx Yik, M., Russell, J. A., & Steiger, J. H. (2011). A 12-point circumplex structure of core affect. Emotion, 11(4), 705–731
xxi ONS (2024). How life has changed in Milton Keynes: Census 2021, accessed from https://www.ons.gov.uk/visualisations/censusareachanges/E06000042/, 12th July 2024.
xxii Ibid
xxiii Nielsen, S. L., Fich, L. B., Roessler, K. K., & Mullins, M. F. (2017). How do patients actually experience and use art in hospitals? The significance of interaction: a user-oriented experimental case study. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267343.
xxiv Yik, M., Russell, J. A., & Steiger, J. H. (2011). A 12-point circumplex structure of core affect. Emotion, 11(4), 705–731
xxv Weiss, Carol (1995). NothingasPracticalasGoodTheory:ExploringTheory-BasedEvaluationfor ComprehensiveCommunityInitiativesforChildrenandFamiliesin ‘New Approaches to Evaluating Community Initiatives’. Aspen Institute.
xxvi Lankston, L., Cusack, P., Fremantle, C., & Isles, C. (2010). Visual art in hospitals: case studies and review of the evidence. Journal of the Royal Society of Medicine, 103(12), 490-499.
xxvii Karnik, M., Printz, B., & Finkel, J. (2014). A hospital's contemporary art collection: effects on patient mood, stress, comfort, and expectations. HERD: Health Environments Research & Design Journal, 7(3), 60-77.
xxviii Nielsen, S. L., Fich, L. B., Roessler, K. K., & Mullins, M. F. (2017). How do patients actually experience and use art in hospitals? The significance of interaction: a user-oriented experimental case study. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267343.
xxix Barclay, S., & James, P. (2009). Not the main game: Art collections in hospital spaces: the Westmead experience. Australasian Journal of ArtsHealth, 1, 78-89.
xxx Nanda, U. P. A. L. I., Hathorn, K. A. T. H. Y., & Newmann, T. (2007). The art-cart program at St. Luke’s Episcopal hospital, Houston. Healthcare Design, 7(7), 10-12.
Cover image: detail of Inside Out (2018), Boyd and Evans, 240 frame photographic work, commissioned artwork for MKUH main entrance.
